In 2017, a 69-year-old man suffering from pancreatic cancer received radiation therapy at Arizona’s Mayo Clinic campus. Two days later, he died unexpectedly at a different hospital and was subsequently cremated. Significantly, Rachel Becker reports for the Verge, crematorium workers remained unaware of the patient’s treatment history until staff from the Mayo Clinic learned of the untimely death and commissioned the Arizona Bureau of Radiation Control to sweep the facility.
The results of this inspection, newly described in a research letter published by the Journal of the American Medical Association, were intriguing: As HealthDay’s Dennis Thompson writes, officials wielding a Geiger counter detected radiation contamination on the crematorium’s oven, vacuum filter and bone crusher. The particle responsible for contamination—lutetium 177—matched the type used for the deceased’s radiation treatment.
“This wasn’t like the second-coming of Chernobyl or Fukushima,” Mayo Clinic radiation safety officer Kevin Nelson tells the Verge, “but it was higher than you would anticipate.”
According to Live Science’s Rafi Letzter, the analysis yielded a maximum Geiger-counter reading of 25,000 counts per minute. In other words, an individual working directly with contaminated equipment would be exposed to roughly 7.5 millirem per hour—enough to exceed established safety levels, but far below the amount needed to cause radiation poisoning.
It’s worth noting, however, that lutetium 177 wasn’t the only radioactive material uncovered by investigators. In fact, Ryan F. Mandelbaum explains for Gizmodo, traces of an entirely distinct particle—technetium-99m—turned up in a crematorium operator’s urine.
Although technetium-99m is regularly used for cardiac imaging and other nuclear medicine procedures, study co-author Nathan Yu, a member of the Mayo Clinic’s radiation oncology team, tells Mandelbaum the operator in question had never undergone a test requiring the radioactive isotope. Instead, it’s likely he or she was exposed to the material during another seemingly routine cremation.
As Susan Scutti observes for CNN, the United States currently lacks federal regulations regarding the cremation of patients treated with radiation. Laws further vary by state, HealthDay’s Thompson notes: Whereas Florida bans the cremation of such patients, Arizona does not.
Combined, the gap in knowledge regarding potential health risks faced by crematorium workers exposed to radiation and the absence of standardized national guidelines for postmortem management point toward a need for both further study and wide-ranging regulation. These next steps are especially crucial given the fact that the U.S.’ current cremation rate is higher than 50 percent, as Mandelbaum reports for Gizmodo.
For now, Nelson tells HealthDay, the key to avoiding radiation contamination is communication.
“If you know a patient at your hospital has a large body burden of radioactive material and they succumb to their disease while in the hospital,” he explains, “you owe it to the funeral home to tell them about that."
Speaking with HealthDay, Paolo Boffetta, a researcher from the Icahn School of Medicine at Mount Sinai who was not involved in the study, concludes, "I don't think this is an issue that may entail any risk of cancer or other radiation-induced illnesses.”
“Having said that,” Boffetta continues, “it's clear it's a possible source of exposure, and if someone is exposed regularly, every week or every few days, then it may become a source of concern. There is a need for a notification process to be put into place."